General characters - College of Nursing · ¥→→ General characters ... ( Extra intestinal amoebiasis) where it produces abscess in liver, lung brain ... LAB. DIAGNOSIS

Protozoa(PR0TOS=PRMITIVE, ZOA= ANIMAL OR ORGANISM)

¥→→ General characters1-Unicellular microorganism ( just one cell) eukaryotic with true

nucleus, cytoplasm and the nucleus contain karyosome.

2-The most important protozoan range usually from 10 to 52 µ.

microscopeare seen easily by -3

4-They move by a variety of organs Pseudopodia, Flagella, Cilia.

5-Perfom all metabolic mechanisms( e.g. Breathing , Digesting, Excretion, Reproduction ( asexually& asexually).

6-They are founding in different parts of the body intestinal lumen, liver ,spleen, blood and tissues, cavities like mouth, UGS…etc.

Classification Of Protozoa

Kingdom :Protista=(simplest of eukaryotic microorganisms) Subkingdom: protozoa

1-Phylum: Sarcomastigophora Subphylum:1- Sarcodina. Ex. Entamoeba histolytica and E.Coli

2- Mastigophora .Leishmania.

2-Phylum: Ciliphora (carrying cilia) Ex. Balantidium coli3-Phylum: Apicomplexa: Like Plasmodium(Malaria).

The Parameters of this study

We can study for each parasite

£→→Morphology of the organism.

£→→ Life cycle, hosts and Vectors.

£→→ Disease, symptoms, pathogenesis.

£→→ Diagnosis, Prevention and control.

£→→ Treatment.

General Morphology

Intestinal, lumen-dwelling protozoa has either both:

£→→ 1-Trophozoite: it is the pathogenic stage or diagnostic stage, usually motile , active, feeding, appear in acute diarrheic infection.

£→→ 2-Cyst stage: it is the infective stage, diagnostic

stage (It is usually non motile , inactive , non feeding appear in the chronic diarrheic infection stage.

£→→ 3-Or It has only Trophozoite without cyst stage.

Entamoeba histolytica

: AMEBIASIS (Amebic dysentery, amebic hepatitis).Disease$$ →

$$ → Epidemiology world wide and more in under developed country 50%.

$$ → habitat is small intestine.

$$ → Infective stage is mature quadrinucleated cyst.

$$ →Pathogenic stage is active trophozoite.

$$ → Diagnostic stage is mature cyst and trophozoite.

$$ → Mode of infection contamination of food and water.

Morphology(Shape)

Trophozoite:-1¥→→also known active vegetative stage. This form has an amoeboid

appearance( no fixed shape ), small actively motile by pseudopodia. Cytoplasm divided into two portions ; a clear ectoplasm and a granular endoplasm. The granular endoplasm may contain ingested erythrocytes.

It is the pathogenic stage.

¥→→ The organism has a single nucleus with a distinctive small central karyosome, trophozoite is the only form present in tissues, it is also found in fluid feces during amebic dysentery.

Mature Cyst: -2¥→→ It is both infective stage and diagnostic stage, spherical in

shape also contain 1 - 4 nuclei with central karyosome.

Troph. And Cyst

A- Trophozoite stage B-Mature cyst stage has 4 nuclei with

central karyosome

A B

Life cycle of E.histolytica

Symptoms$$ → Acute: Amoebic dysentery with necrotic mucosa

and abdominal pain.

$$ → Chronic: Recurrent dysentery with blood and mucus in the feces. There are gastro-intestinal disturbances & constipation.

$$ → Trophozoite may found in acute bloody dysenteric stool.

$$ → Cysts are found in the chronic formed stool.

$$ → The organism may invade the liver, lung and brain ( Extra intestinal amoebiasis) where it

produces abscess in liver, lung brain…etc & this is called systemic infection.

PATHOLOGY

₱→Pathology:

₱→ Intestinal infection.

₱→ Extra-intestinal infection.

₱→ Intestinal ulcers /flasks are due to enzymatic ameboma. degradation of tissue and may be

₱→ Extra intestinal: (Systemic Infection) .liver abscess, sometimes brain, lung and spleen abscesses can also occur.

₱→ liver is the most common extra-intestinal organ

involved.

PATHOLOGY IN SUMMARY

PATHOLOGY

FLASK-SHAPED ULCER LIVER ABSCESS

LAB. DIAGNOSIS

₱→ Symptoms→ confirmed by finding

Trophozoite in blood diarrhea or cysts

in the formed stool.

₱→ Distinct from bacillary dysentery due to

lack and absence PMN.

₱→ Differentiation must be made from

nonpathogenic intestinal protozoa.

(EX. Entamoeba coli).

Prevention and control:Determin:

₱→ The source of infection by lab. Tests.

₱→ Symptomatic cyst carriers detection.

₱→ Diagnose and treat the cases.

₱→ Improvement water supply and sewages.

₱→ Good health education.

Treatment₱→ Two classes are used in treatment of

amoebiasis –the luminal infection drugs e.g. Iodoquinol and tetracycline.

₱→ Tissue amoebiasis are treated by

(emetine and chloroquine) which they are effective in systemic infection.

₱→ Metronidazole for both sites

₱→ The dose depends on:

1-Severity of the parasite infection(Burden).

2-Infected organ(If it is local or systemic).

3-Age of patients.

2-Age of patients.

Entamoeba coli :

¥→This parasite is non- pathogenic &lives commensally in large intestine of human

¥→ It has the same life cycle of E.histolytica

but it differs in some properties

Differences between E.histolyticaand E.coli

Subphylum: Ciliphora

Balantidium coliDisease : Balantidiasis or Balantidial dysentery:

£→→ Balantidium coli is the only ciliate known to parasitize humans. Ciliates represent a phylum of protozoa characterized by simple or compound ciliary organelles on the surface of their membranes that are used for locomotion.

£→→ Ciliates have 2 nuclei (one macronucleus and one micronucleus) and reproduce by transverse binary fission or by conjugation.

£→→ Balantidium coli has 2 contractile vacuoles. Although contractile protozoa, which parasiticvacuoles are common to ciliates, they are rare in

suggests that Balantidium coli has a unique osmoregulatory capacity.

£→→ Balantidium coli has 2 developmental stages: a trophozoite stage and cyst stage.

Balantidium coli

trophozoite cyst

Life cycle

Symptoms:Clinical Disease

££→→ Symptoms and Pathogenesis of balantidiasis are similar to those seen in amoebiasis including

BLOODYintestinal epithelial erosion, diarrhea, nausea, vomiting and anorexia.

££→→ The bloody diarrhea may persist for long periods of time resulting in acute fluid loss.

££→→ B. coli also has ability to penetrate the mucosa resulting in ulceration.

££→→Extra-intestinal disease has also been reported

BUT RARELY.

TRANSMISSION₱→To the human feco-oral transmission is rare

but possible(Accidentally ).

TREATMENT:

1-Metronidazole and iodoquinol are effective.

2-Oxytetracyclin.